Analysis of influencing factors of radial artery puncture point bleeding after radial artery puncture and catheterization for intracranial aneurysm treatment

doi:10.3877/cma.j.issn.2095-9141.2025.04.005

Abstract

Abstract:

Objective

To analyze the influencing factors of bleeding events in patients with anterior circulation intracranial aneurysms after endovascular treatment via transradial approach (TRA).

Methods

Ninety-eight patients with anterior circulation intracranial aneurysms treated with TRA endovascular therapy at Neurosurgery Department of the Second Affiliated Hospital of Nantong University from July 2022 to April 2024 were selected as the study subjects. The patients were divided into the bleeding group (41 cases) and the non-bleeding group (57 cases) according to whether bleeding events occurred after treatment. The general information, past history, preoperative blood test results, and intraoperative operating indicators of the two groups of patients were collected, and single factor and Logistic multifactor regression were used to analyze the influencing factors of bleeding events after TRA endovascular therapy.

Results

Compared with the non-bleeding group, the bleeding group had a higher proportion of patients with the following characteristics: age ≥60 years, hypertension, diabetes mellitus, long-term smoking, guide catheter positioning time ≥12 min, total hemostat release time <1200 min, vascular tortuosity in the arterial access, and hemoglobin level <134.86 g/L (all P<0.05). Multivariate Logistic regression analysis revealed that patient age ≥60 years, history of hypertension, history of diabetes mellitus, long-term smoking history, vascular tortuosity in the arterial access, preoperative hemoglobin level <134.86 g/L, surgical guide catheter positioning time ≥12 min, and total hemostat release time <1200 min were all independent influencing factors for bleeding events during TRA endovascular treatment (all P<0.05).

Conclusions

Patients with anterior circulation intracranial aneurysms who have the following characteristics with the following characteristics, including age≥60 years, history of hypertension, history of diabetes mellitus, long-term smoking history, vascular tortuosity in the arterial access, preoperative hemoglobin level <134.86 g/L, surgical guide catheter positioning time ≥12 min, and total hemostat release time <1200 min have a high risk of bleeding events after TRA endovascular treatment.

Key words: Anterior circulation intracranial aneurysm, Bleeding events, Transradial approach, Endovascular treatment, Influencing factors

Zhenhua Chen, Yong Dai, Jialei Chen, Zhenghua Cai, Xiangyang Zhu, Gang Cai. Analysis of influencing factors of radial artery puncture point bleeding after radial artery puncture and catheterization for intracranial aneurysm treatment[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2025, 11(04): 238-242.

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References 21

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项目	出血组（n=41）	未出血组（n=57）	χ²/t值	P值
性别[例（%）]			0.167	0.683
男	24（58.54）	31（54.39）
女	17（41.46）	26（45.61）
年龄[例（%）]			5.577	0.018
≥60岁	25（60.98）	21（36.84）
<60岁	16（39.02）	36（63.16）
高血压史[例（%）]	28（68.29）	21（36.84）	9.435	0.002
糖尿病史[例（%）]	26（63.41）	19（33.33）	8.689	0.003
长期吸烟史[例（%）]	23（56.10）	15（26.32）	8.909	0.003
指引管到位时间[例（%）]			5.654	0.017
≥12 min	22（53.66）	17（29.82）
<12 min	19（46.34）	40（70.18）
手术时间[例（%）]			2.739	0.098
≥100 min	22（53.66）	21（36.84）
<100 min	19（46.34）	36（63.16）
全松止血器时间[例（%）]			4.785	0.029
≥1200 min	16（39.02）	35（61.40）
<1200 min	25（60.98）	22（38.60）
动脉路径血管迂曲[例（%）]	11（26.83）	5（8.77）	5.692	0.017
血红蛋白（g/L，±s）	131.24±13.15	137.32±14.03	2.172	0.032
红细胞压积（±s）	0.41±0.04	0.42±0.05	1.059	0.292
血小板计数（×10⁹/L，±s）	178.36±39.87	193.73±42.33	1.816	0.072
凝血酶原时间（s，±s）	11.23±0.97	11.36±1.08	0.613	0.541

项目	出血组（n=41）	未出血组（n=57）	χ²/t值	P值
性别[例（%）]			0.167	0.683
男	24（58.54）	31（54.39）
女	17（41.46）	26（45.61）
年龄[例（%）]			5.577	0.018
≥60岁	25（60.98）	21（36.84）
<60岁	16（39.02）	36（63.16）
高血压史[例（%）]	28（68.29）	21（36.84）	9.435	0.002
糖尿病史[例（%）]	26（63.41）	19（33.33）	8.689	0.003
长期吸烟史[例（%）]	23（56.10）	15（26.32）	8.909	0.003
指引管到位时间[例（%）]			5.654	0.017
≥12 min	22（53.66）	17（29.82）
<12 min	19（46.34）	40（70.18）
手术时间[例（%）]			2.739	0.098
≥100 min	22（53.66）	21（36.84）
<100 min	19（46.34）	36（63.16）
全松止血器时间[例（%）]			4.785	0.029
≥1200 min	16（39.02）	35（61.40）
<1200 min	25（60.98）	22（38.60）
动脉路径血管迂曲[例（%）]	11（26.83）	5（8.77）	5.692	0.017
血红蛋白（g/L，±s）	131.24±13.15	137.32±14.03	2.172	0.032
红细胞压积（±s）	0.41±0.04	0.42±0.05	1.059	0.292
血小板计数（×10⁹/L，±s）	178.36±39.87	193.73±42.33	1.816	0.072
凝血酶原时间（s，±s）	11.23±0.97	11.36±1.08	0.613	0.541

项目	偏回归系数	标准误	Wald值	OR值	95%CI	P值
年龄≥60岁	1.465	0.592	6.118	4.329	1.356~13.824	0.013
高血压史	1.301	0.594	4.803	3.672	1.147~11.753	0.028
糖尿病史	1.286	0.599	4.604	3.617	1.118~11.701	0.032
长期吸烟史	1.484	0.604	6.033	4.412	1.350~14.422	0.014
指引管到位时间≥12 min	1.856	0.658	7.944	6.395	1.760~23.240	0.002
全松止血器时间<1200 min	1.371	0.653	4.414	3.941	1.096~14.164	0.036
动脉路径血管迂曲	1.811	0.785	5.321	6.116	1.131~28.492	0.021
术前血红蛋白水平<134.86 g/L	1.414	0.613	5.321	4.111	1.237~13.664	0.021
常数	-17.618	3.477	25.677	-	-	<0.001

项目	偏回归系数	标准误	Wald值	OR值	95%CI	P值
年龄≥60岁	1.465	0.592	6.118	4.329	1.356~13.824	0.013
高血压史	1.301	0.594	4.803	3.672	1.147~11.753	0.028
糖尿病史	1.286	0.599	4.604	3.617	1.118~11.701	0.032
长期吸烟史	1.484	0.604	6.033	4.412	1.350~14.422	0.014
指引管到位时间≥12 min	1.856	0.658	7.944	6.395	1.760~23.240	0.002
全松止血器时间<1200 min	1.371	0.653	4.414	3.941	1.096~14.164	0.036
动脉路径血管迂曲	1.811	0.785	5.321	6.116	1.131~28.492	0.021
术前血红蛋白水平<134.86 g/L	1.414	0.613	5.321	4.111	1.237~13.664	0.021
常数	-17.618	3.477	25.677	-	-	<0.001

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